Davidson County Board of Health Minutes Regular Meeting of the Board of Health Health Department Boardroom April 1, 2025 Board of Health Present Staff Present Visitors Present Dr. Terry Ellington, Chair Lillian Koontz Adam Jones, County Attorney Mr. Calvin Odom, Vice Chair Janna Walker Jonathan Ray, CEO, Davidson Water Commissioner Tripp Kester Corinne Bates Andrew King Ms. Tammy Troublefield Stacy Hull Dr. David "Rob" Williams, Jr. Randy Swicegood Mr. Justin Nifong Mary Lou Collett Dr. Mark Hamrick Michelle Allen Dr. Christian Brandyberry Belinda Wilson Ms. Datra Delk-Patrick I. Welcome, Introductions, Announcements - Dr. Terry Ellington Dr. Ellington called the meeting to order at 3:00pm, welcomed everyone to the meeting, and introduced Mr. Jonathan Ray from Davidson Water who came to share a presentation regarding fluoride. Dr. Ellington and Ms. Lillian Koontz also recognized Ms. Tammy Troublefield who has served the maximum term of 9 years on the Board of Health (Board). They thanked Ms. Troublefield for her years of service and for her contributions to the Board which included serving as Chair and Vice Chair during her time on the Board. Ms. Troublefield thanked everyone and shared that she enjoyed her time on the Board and learned a great deal. II. Agenda - Discussion and Amendments = Dr. Terry Ellington There were no amendments or discussion. Commissioner Tripp Kester made a motion to accept the agenda, and Dr. Mark Hamrick seconded the motion. The motion was approved without dissent. III. Public Comment None IV. Consent Agenda = Dr. Terry Ellington The consent agenda which was part of the meeting packet was presented and included the March 4, 2025 meeting minutes, the financial report as presented and the 100.64 Patient Identity-Medical Record policy. Ms. Datra Delk-Patrick made a motion to accept the consent agenda, and Ms. Troublefield seconded the motion. The motion was approved without dissent. V. Commissioner's Report None VI. Health Director's Report (Including Program Reports) = Ms. Lillian Koontz Ms. Koontz reviewed the following highlights from the Health Director's Report: We are recruiting for two open positions in WIC, Office Support III/Medical Office Asst. and Lab/Breastfeeding Peer Counselor; An offer was made and accepted today for the office support position in Environmental Health (EH); We are holding on 3 open positions in clinic; The Communicable Disease (CD) nurse position has been offered and accepted; April is Public Health Month. I have attended several local municipality meetings to accept proclamations proclaiming April as Public Health Month; This Saturday we will be having a rabies clinic here at the health department; Representative Larry Potts was awarded the NC Association of Local Health Directors Legislator of the Year, and we have received a request from Randolph County which we will talk more about later in the meeting. Ms. Koontz also shared a financial update regarding federal funding. We have received a stop work order from DHHS (Department of Health and Human Services) for two agreement addenda for the state of North Carolina which are the Seasonal Influenza Vaccine for Farmworkers and the CDC COVID 19 Vaccination Program. The addenda for vaccine for farmworkers is not available in Davidson County, SO it did not affect us. We do have the CDC COVID 19 Vaccination Program. There is only $8,663.04 of funding remaining for this program which we will not be allowed to use. This loss of funding will not impact any services here at the Health Department. Ms. Koontz also reviewed the bills related to public health that are being considered in the legislative session. HB 197: This bill will provide funding for the CD program at the local level. The primary sponsor for this bill is Representative Potts who has been very instrumental in helping to get funding for communicable disease work at the local level which is very underfunded. HB 430/SB 318: This bill will provide protection from vaping and nicotine for our youth and will prohibit the sale of tobacco to those under the age of 21. Per federal law, the age requirement to purchase nicotine products is 21; however, for the State of North Carolina it is 18, making the law unenforceable. This bill will change the state age limitt to 21 to match the federal law, SO the law can be enforced. HB 376: This will impact Onsite Water Protection (OSWP) and well provisions. One concern with this bill was an early addition of a proposal eliminating the expiration of a septic permit. As of now the expiration date for a septic permit expires 5 years from the date of issuance. Once it expires you must reapply for another permit. This legislation would have removed the 5-year expiration date which means a septic permit would never expire. This legislation could create more problems as there could be changes to the condition of the site. Mr. Randy Swicegood, EH Director OSWP, added that there is already a path to a lifetime permit, but it is much more stringent to get as compared to the new proposal which would eliminate the expiration date on all permits. There were several agencies opposed to this change. Board members commented that changes to a site could occur even after one year. Ms. Koontz stated that this language was stricken from the bill. There are other provisions in the bill and most of them are doable. Mr. Swicegood stated that nothing in the bill will affect Davidson County but will affect some local rules. There are some counties with rules that are more stringent than the state. This bill will make the rules of all counties in NC more in line with those of the state. HB 519: This bill deals with the Parents' Bill of Rights and minor consent laws. This is a legislative action that is already in place, but they are discussing enhancing it to address some of the concerns raised by the public. For example, there are challenges for a parent trying to get into their child's MyChart, because the parent is not the actual patient. HB 89/HB 380: This deals with the University Vaccine Freedom Act and Conscientious Objections to Vaccine Mandates. Ms. Koontz stated that she does not know a lot about these bills, since there are not any mandates for vaccines in our health department or anywhere else in the local government. HB 491: This is regarding Medicaid work requirements. This bill states that if the federal government adopts any work requirements, North Carolina will do the same. SB 403: This is about death and birth certificate requirement amendments. There will be a 30- day requirement to process birth and death certificate amendments. These certificates are processed here at the Health Department, but we are dependent on others such as the medical examiner, funeral home, and the Register of Deeds. If everything goes smoothly these are done within 30 days. If there is a hold-up with the medical examiner for cause of death or a challenge at the funeral home, we could be butting up against the 30-day requirement. We will be keeping an eye on this bill. Dr. Rob Williams asked if there was a penalty for not meeting the deadline, and Ms. Koontz replied that as of now there is no penalty. There was more discussion as to why a requirement would be made if there was not a penalty or a way to enforce it. Ms. Koontz stated that she believes they are still trying to figure that part out. There was also discussion regarding time requirements in legislation, if additional funding would be required for the 30-day deadline, and if additional funding would be provided by the State. Unfunded mandates were also discussed. Ms. Koontz stated that she will keep these bills on her radar and will report back if any of them survive the crossover deadline. Ms. Koontz presented a slide showing two packages of popular candies marketed toward children and two packages of candy containing THC that are almost identical to the name brand candy marketed to children. Ms. Koontz stated that she received an email from Randolph County stating that their Board of Health (BOH) has written a letter to legislators in support of legislation that will prohibit the sale or distribution of these products to those under 21 and to request regulations regarding packaging. The Randolph County BOH would like to see other boards of health write letters to their legislators in support of this legislation. Ms. Koontz stated that she would be glad to draft a letter at the Board's pleasure to send via email to our legislators. Mr. Justin Nifong stated that his only issue with the language is that he wasn't sure that the state would be able to regulate packaging, since it would probably be a federal issue. He stated that this should be supported, but there may be things in the letter that the state cannot do. More discussion followed regarding the language of the letter. Dr. Ellington made a motion for Ms. Koontz to draft a letter of concern to our legislators, and Commissioner Kester seconded the motion. The motion was approved without dissent. Ms. Koontz stated that she will get the letter drafted and send it out to the BOH for approval. Ms. Koontz also shared the following highlights from the program reports: Congratulations to Michelle Allen, WIC Director, and her team for great results from their audit; We have a new pharmacy manager; We are interviewing for our open WIC positions; The Community Health Needs Assessment survey is underway. Ms. Janna Walker, Health Promotions Director, has sent that information out, and we are trying to get more responses in; Our new hire in OSWP is working toward his authorization; Food and Lodging is preparing for pool season, and Ms. Corinne Bates, Business Officer, is working hard on the budget to get it to the finish line. VII. Old Business a. Fluoride In Public Water = Mr. Jonathan Ray, Davidson Water Mr. Jonathan Ray, CEO of Davidson Water, presented a presentation prepared by Mr. Terry Crowe on fluoride in public water. Mr. Ray explained what fluoride is and shared that the State of North Carolina does not mandate fluoridation. Local governments are in control of fluoridation policies in NC. Since Davidson Water is a member owned cooperative, the Davidson Water, Inc. Board sets their policy regarding fluoridation. He also shared monitoring requirements, and a brief history of fluoride. Davidson Water does add fluoride to the water, and he shared information about the testing procedures and what the levels were for February 2025. Mr. Ray also shared some of the following actions taken by local governments in 2024: On February 19, the Union County Board of Commissioners voted 3 to 2 in favor of banning fluoride in drinking water. In Davidson County, fluoride was discussed by the Thomasville City Council, but no vote was taken. He also shared the following actions that were taken nationally: On September 25, 2024, a federal judge ordered the U.S. Environmental Protection Agency to further regulate fluoride in drinking water, because high levels could pose a risk to the intellectual development of children; Last Friday, Utah. became the first state to ban fluoride in public drinking water. Mr. Ray discussed what the future holds regarding fluoride and stated that the Davidson Water, Inc. Board of Directors will continue to evaluate the addition of fluoride. He also stated that Davidson Water has no current plans to discontinue the addition of fluoride; however, this could change if there is a threat to the company for adding fluoride. Mr. Ray asked if there were any questions. Dr. Ellington asked how many places the water is checked. Mr. Ray stated that they check the raw water at the river, and then it is checked at the entry point, which is before the water enters the distribution system. Dr. Ellington and Dr. Williams stated that the data presented showed huge variations in the raw water. Mr. Ray stated that they do a split sample every month which is tested by the state and Davidson Water. If there is more than a 15% difference, then the state would do further investigation. Dr. Williams asked how much fluoride must be added on average to get to the recommended level. Mr. Ray stated that a load of 40,000 pounds lasts for a year. Ms. Koontz asked Dr. Christian Brandyberry to explain why fluoride treatments are done at dentist offices and does that mean we are not getting enough fluoride in our water. Dr. Brandyberry stated that topical fluoride treatments are done at dentist offices, since they do not know what level of fluoride patients are getting. Some patients may be on well, city or county water. Dr. Brandyberry stated that if fluoride was removed from public drinking water, you will see an increase in cavities in children and adults. Ms. Koontz asked Dr. Brandyberry if there were other ways of getting fluoride. He stated that a lot of toothpastes have fluoride in them. Dr. Ellington asked if you would be able to get enough fluoride from toothpaste and other dental products to reduce or prevent cavities if the fluoride was taken out of the water. Dr Brandyberry replied that with the products available on the market you would be able to get enough fluoride, but he also stressed the importance of teaching patients better home care and dietary education regarding teeth. VIII. New Business a. Child Fatality Protection Team Report - Ms. Mary Lou Collett Ms. Collett, Nursing Director, explained that this is a community team, and as a team, we reviewed 26 deaths that occurred in 2023. This has been mentioned previously, but the legislation is changing July 1st. After July 1st, we will not review deaths for those who did not survive preterm births. A lot of the deaths that are occurring are from un-safe sleep practices, and we will continue to review those. We did send a letter at the request of a BOH member to diaper manufacturers in Davidson County requesting safe sleep messaging on diapers instead of cartoon characters, but we did not receive a response back. We are hoping to be able to distribute more pack and plays. We had some child health monies which we were able to use to purchase pack and plays. These were distributed through local pediatrician offices and local law enforcement agencies. This is very helpful to families who do not have a safe place for their babies to sleep. We have also partnered with Daymark and other treatment facilities to provide safe sleep education to their clients. Ms. Koontz also stated that the people on this committee are very passionate about trying to improve health outcomes for the children of Davidson County. We are working really hard on reducing the deaths from un-safe sleep practices. It is frustrating that we did not receive responses from the letters that went out to the diaper manufacturers. We have also sent samples of our safe sleep onesies to the state, SO they can talk about it at the state level. These are onesies that have the ABCs of safe sleep on the front, and on the back, it has "Turn Me Over.' 1 We give these out through our care management program. These deaths are preventable, and we want to get the message out about safe sleep practices. Ms. Troublefield asked if the pack and plays had to be new. Ms. Collett replied that the ones they distribute must be new. b. Child Health Report Card = Ms. Mary Lou Collett Ms. Collett stated that the Child Health Report Card has not come out yet. She is not sure what the delay is, but if it is out when she presents the School Health Report, she will share the Child Health Report Card along with the School Health Report. C. 2024 State of the County Health Report (SOTCH) - Ms. Janna Walker Ms. Walker stated that 2024 should typically be a Community Health Needs Assessment (CHNA) year, but in this cycle, we have done three SOTCH reports. Ms. Walker reviewed the 2024 SOTCH report, which is a snapshot of the population showing demographic changes. She mentioned some of the following highlights from the report which included an increase in the population, a decrease in the birth rate and life expectancy rate, and a significant increase in the mortality rate which could be contributed to many factors. We will be able to explore this more in the CHNA (Community Health Needs Assessment) where we will be looking at chronic diseases, cancer, child deaths and many other things and how this contributes to the overall health of the community. Ms. Walker also presented a slide of the median household income and poverty level in Davidson County. About 34% of our population lives in poverty and 45% of those under 18 live in poverty. This emphasizes how important the school health and school meal programs are to the children in Davidson County. There are some programs that we have been helping with that make sure children go home with food in their backpacks. For the purpose of the SOTCH report, we like to look at the updates on demographics and health outcomes. We have not had any major new, paused or discontinued initiatives in this cycle. Our next steps will be to continue to collect information for this current CHNA, and then we will get into setting priorities and start looking again at all these things we have just mentioned. There were no questions for Ms. Walker. Dr Ellington announced that the next BOH meeting will be Tuesday, June 3, 2025 at 3:00pm. IX. Adjournment Ms. Troublefield made a motion to adjourn. Commissioner Kester seconded the motion. The motion carried without dissent. This meeting was recorded and is available for viewing in its entirety on the Health Department website at https://www.co. davidson.nc. WAmaceasatiaN These minutes reflect actions and an overview of conversation during the meeting. The presentation slides from the meeting are also attached to these minutes. This is a true and accurate copy of the April 1, 2025 Board of Health Minutes. Respectfully submitted, Dliov Koos Ms. Lillian Koontz, MPH, REHS Secretary to the Board 1/ Dr. TerryEllington Chair to the Board Consent Agenda Health Director's Report: State of the Agency Open Positions, Recruiting NEWS Minutes WIC: Office Support II, Medical Office Assistant: April is public health month! Meeting March 4, 2025 Laba andF Peer Counselor Rabies Clinic, April5 Representativel Larry Potts was awardedt thel NC Financial Report Open Positions, Holding Association ofl Local Health Directors Legislator o linic:P Provider the) Year Clinic: Nurse Policies Office Support Clinic: Office! Support IV Legislative Session . 100.64 Patient dentity-Medical Record Randolph County Ask Health Director's Session Director's Health Report:, Report: Legislative Financial Update e HB 197 HB519 Stop Work Order . Filed 2/25 Parents' Medical Bill of Rights Termination of Federal Funding Local CD funds Minor consent laws Costs incurred after March 24, 2025 may not be Primary Sponsor, Rep. Potts HB8 HB 380 reimbursed 89 / HB 430/ SB 318 University Vaccine Freedom Act e Filed 3/18 Conscientious Objection to Vaccine AAT 716: CDC COVID 19 Vaccination Program Vaping & Nicotine Youth Protection Mandates Received in 2021 $467,436 rolled over each year Tobacco 21 HB $8,663.04 remaining 491 Regulatory requirements Medicaid Work Requirements AA 720: Seasonal Influenza Vaccinei for Farmworkers HB 376 NCI will adopt Federal requirements Not available in Davidson County Filed 3/11 SB 403 Various OSWP & Well Provisions . 30-day requirement to process birth and death certificate amendments L Gou3 NORSS Cu te GS Skyug rainDon U ICMED StuD SoEp 0 - Skittles CRdy 400 Bears March 24, Randolph County Health Director requests support for RC BOH initiative Randolph County Restrict the sale and accessibility of hemp products to children and youth in NC Ask NCC Child Fatality Task Force recommendation: "Support legislation to prevent child and youth Support access to intoxicating cannabis by: prohibiting the sale or distribution of intoxicating cannabis or hemp products tot those under 21; implementing regulations for the packaging of such products to require appropriate warnings, child-resistant packaging, and to prohibit packaging that is attractive to children and youth; requiring permitting for retailers who sell intoxicating cannabis or hemp products; and prohibiting those under 21 from entering vape shops." Program Reports . CHNA survey is underway . WIC audit completed: glowing review of the program and team . New hire in OSWP is working towards authorization FLUORIDE New pharmacy manager: Madhia Hassan . F&L preparing for pool and festival season Interviewing for open WIC positions TERRY CROWE AGENDA WHAT IS FLUORIDE REGULATIONS BRIEF HISTORY CURRENT EVENTS WHAT IS THE FUTURE DAVIDSON WATER COST WHAT IS FLUORIDE ? OR IN OUR CASE YDROFLUOSILICIO ACID O Hydrofluosilicic acid, also PHYSICAL STATE: COLORLESS known as fluorosilicic acid is LIQUID primarily used in water D IT'S A STRONG ACID AND NEEDS TO treatment for the purpose of BE HANDLED WITH CARE. adding fluoride to public D THE MOST COMMON METHOD OF water supplies (water WATER FLUORIDATION IN THE fluoridation) as it readily UNITED STATES. releases fluoride ions when J BYPRODUCT OF PHOSPHATE mixed with water. FERTILIZER PRODUCTION. REGULATIONS NORTH CAROLINA LAW The State of North Carolina does not mandate fluoridation. Local governments control fluoridation, policy in. NC. City councils can begin or discontinue fluoridation, at their discretion, or by a referendum vote. NC also allows individual schools that have their own water supply to fluoridate school water. Administrative, çode Title 10A, r. 40A.0306 requires that the state Department of Health, as well as the students' parents be notified prior to implementation of in-school fluoridation programs. MONITORING REQUIREMENTS AND MCL Parameter Primary MCL Secondary MCL Fluoride 4.0 mg/l 2.0 mg/l legally-enforceable limit non-enforceable guidelines that address that is known to affect aesthetic concerns like public health. taste, odor, and color 1) Daily Monitoring. A supplier of water shall measure thet fluoride concentration at least once per day at each entry point to the distribution system with fluoridated water 2) Split Samples. One entry point sample collected pursuant to Subparagraph (cX1) of this Rule shall be split equally on. a. monthly. basis. One portion shall be analyzed by water system personnel and the other portion analyzed byt the North Carolina State Laboratory for Public Health or another laboratory certified to analyze drinking water samples for fluoride by the! North Carolina State Laboratory of Public Health. A: supplier of water that has all fluoride samples under this Rule analyzed by a laboratory certified to analyze drinking water samples for fluoride by the North Carolina State Laboratory for Public Health shall not be required to conduct split sampling. 3) Discrepancies. A: supplier of water shall compare the results of the split samples and shall consult with the North Carolina State Laboratory of Public Health to investigate and resolve all discrepancies greater than 15 percent within 30 days of receipt. 4) Annual Raw Water Sample. A: supplier of water shall measure the fluoride concentration of the raw water at least annually by a laboratory certified to analyze fluoride in drinking water by thel North Carolina State Laboratory of Public Health. BRIEF HISTORY Studies found that adding fluoride to water reduced tooth decay in children The CDC named fluoridation one of the 10" "great public health achievements of the 20th century. 1949 1969 Charlotte became the first The North Carolina Citizens city in North Carolina to Committee for Dental Health add fluoride to its water lobbied for funds to buy supply fluoridation equipment 1966 North Carolina held a conference in Greensboro to promote community fluoridation BRIEF ISTORY Researchers found that in counties where more than 75 percent of they population had access tot fluoridated water, there was à 30 percent decreasei in tooth decay inj primary teeth and a 12p percent decrease in adolescent teeth compared with county populations that had less access. CONTINUED 2015 1978 Water systems advised to go to a The US. Surgeon General movest the concentration of 0.7 mg/L ofi fluoride in National Fluoridation Programt tot the drinking water, ensuring prevention Centers for Disease Control (CDC). The benefits while minimizing 75 risk of CDC continues to oversee and offer dental fluorosis. Consequently, public guidance, along with technical support, water systems nationwide commence tos state andt territorial fluoridation fluoridation at the recommended 0.7 ppm programs upt tot the present day. level. 2012 Fluoridated water is supplied to three- quarters of Americans (74.6%) through public water systems, while 67.1% oft the overall U.S. population has access to fluoridated tap water. DAVIDSON WATER OPERATION TYPICAL FLUORIDE OPERATION Wei test for fluoride levels in both the raw and finished water once per day During the month of February, raw water (Yadkin River) fluoride levels ranged from 0.01 to 0.30 ppm We attempt to control fluoride addition such that the level in the finished water is at or just below 0.70 ppm During the month of February, finished water fluoride readings ranged from 0.38 to 0.69 ppm CURRENT EVENTS THE UNION COUNTY BOARD OF COMMISSIONERS VOTED 3-2 FEB 19 TO BAN FLUORIDE IN THE DRINKING WATER. - IN STANLY COUNTY, THE COUNTY'S BOARD OF COMMISSIONERS, AND THE CITY COUNCIL OF ALBEMARLE HEARD PRESENTATIONS ON THE TOPIC IN MARCH BUT TOOK NO ACTION. KINGS MOUNTAIN IN CLEVELAND COUNTY WAS SCHEDULED TO CONSIDER A MEASURE TO REMOVE FLUORIDE FROM THE CITY'S DRINKING WATER, BUT THAT DIDN'T HAPPEN. LOCAL GOVERNMENT ACTIONS - 2024 IN DAVIDSON COUNTY, THE THOMASVILLE CITY COUNCIL DISCUSSED THE ISSUE AS WELL, BUT TOOK NO VOTE. NATIONAL NEWS 9/25/2024 NEW YORK (AP)- A1 federalj judgel has orderedt thel U.S. Environmentall Protection Agency tof further regulate fluoridei in drinking water becausel high levels could pose. risk tot the intellectual development of children. 3/28/2025 E GNNHealth Life,ButBetter Fitness Food Sleep Mindfuiness Relationships OWatch QListen LiveTV Q Signin Utah becomes the first state to ban fluoride in public drinking water ByA AssociatedPress 03mnterad- Updated 14P PMEDT, FriMarch: 28, 2025 WHAT IS THE FUTURE ? North Carolina From: Guidry, Virginial I <Virginia. Guidry@dhhs.r nc govo smiMo-.ea.2? 20251104AM To:T Terry Crowe IETOMEBGNVESONMStEA com> Cc:Moore, Zack czack moore@dhhs.nc gove; Roberson, Patrick M patrickroberson@dh ncgovo Subject: RE: [External) Fluoride o North Carolina is conducting a study Mr. Crowe, on the Neurotoxicity of Fluoride. The report was supposed to be Thanks for your message ands sorryf for the delay whileiwasout lastweek. Wea are following thisi issue cosely as new informa tion continues toe emerge but right nowt the NCDHHS guidanceofo7 millige offluon de per Biterofwater completed by December of 2024. It remi ged. amr not aware of any regulatory actions currently n the works. https/lwww.dph hamhmlnihamde. and-education/ i Vo oride-facts has been extended. NCDHHS recommends waiting for the final National Toxicology Program report to complete any assessment of health risks of fluoride in drinking Alsoc copying! Dr. Patrick Roberson, State Dental Director and Oral Health Section Chief, and Dr. Zacki Moore, State water. Epidemiologist: and Epidemiology Section Chief, inc case they! have additional linformation to share. Kindn regards, 0 North Carolina still stands by 2014 Virginia Guidry recommendation. Virginia T. Guidry, PhD, MPH Branch Head, Occupational andE Environmental Epidemiology Divisionc ofF Public Health, Epidemiology Section North Carolina DepatmentofH Healtha andh Humans Services FUTURE OF FLUORIDE Organizations that support the use of fluoride: AT DAVIDSON WATER American Academy of Pediatrics, U.S. Public Health Service, World Health Organization, American Dental Association, CDC, American Water Works Association The Davidson Water, Inc Board of Directors will continue to evaluate the addition of fluoride with the help of management and utilizing the recommendations of governmental and industry organizations Currently there are no plans to discontinue adding fluoride However, if it appears there could be a threat to the company for adding fluoride, that stance could change 2023 reviewed a total of 26 deaths Child Fatality 8 oft those deaths were children 5 years ofa age or older Prevention Team Team recommends continued work regarding hazards of co-sleeping letters (CFPT) Have sent to diaper manufacturers requesting safe sleep messaging Seek funding for purchase of pack- and-plays to be distributed by LEO when witnessing unsafe sleep arrangements Partnered with Daymark and working with other Treatment Facilities to provide safe sleep education Child Health nnn) STATE OF THE COUNTY HEALTH REPORT Report Card LUL Have not released the new report, will provide at a later meeting Population 2019-2023 Winston- Salo on ri lington Davidson County: 171,063 residents Greensboro 57,119 Rleasan nt 27,846 143 rem ine Concord Demographics by Age, Davidson County 2019-2023 70 60 59.59 50 40 of 30 34.47 % 20 25.12 21.79 18.61 16.44 10 5.35 0-4 years 0-17 years 5-17 years 18-64 years 18-39 years 40-64 years 65 and older Age Created on Metopiol Imetoplo/V6gkatlel Data sources: US Census Bureau: American Community Survey (ACS) (Table B01001), US Census Bureaur Decennial Census (2020 datad only) Demographics Percent ofr residents within eachr major demographic group. Use this to explore age. gender, and racial/ethnic breakdowns. This data S expressed asa percent: tos see breakdown ofa all residents by count usel Population. Median household income Percent Population with Income at or Below 200% FPL Davidson County and comparison 72.5K $69,904 70K $67,958 $68,151 $67,037 67.5K $65,040 0% 100% 65K $63,462 Davidson County,NC $62,677 $62,426 (34.2299) 62.5K $61,088 $60,542 North Carolina 3 (31.03%) $59,773 $59,923 $59,714 $59,611 $60,209 United States (28.46%) 60K $59,017 $57,054 $57,236 57.5K $56,294 $56,294 $55,441 $54,874 Population Under Age 18 55K Below 200% FPL, Percent 52.5K 50K 0% 100% / / / / A / / / / / / Davidson County, NC * Davidson County North Carolina (45.619) North Carolina (40.42%) Created on Metopiol metopio/lgi2bgra) Datas source: US Census Bureaur American Community Survey (ACS) (Table B19013) United States (36.63%) Median ho ouseholdi income: Income int thep past 121 months Livel birthr rate (NC) Dav 125 12.3 123 12.0 2 119 11.7 Mortality rate, all causes 15 115 114 113 Davidson County and comparison 1400 5 1,287.2 1300 10.7 10.7 10.7 1,253.2 106 10.5 10.5 105 105 104 1200 1100 - 2011-2015 012-2016 2013-2017 2014-2018 2015-2019 2016-2020 2017-2021 2018-2022 & 5 1000 e Lifee expectancy 881.5 884.3 889.3 880.4 883.5 879.0 891,6 900 871.9 Davidse - 838.5 846.4 32 7924 786.6 784.0 782.4 782.3 780.6 778.7 792.9 800 700 78.0 78.1 77.7 4 764 6.6 / / / / / / / / A / / 75.8 . Davidsonc County . North Carolina 72 2016-2018 2017-2019 2018-2020 2019-2021 ONGOING & EMERGING ISSUES NEW/PAUSED/DISCONTINUED INITIATIVES SINCE LAST CHA NEXT STEPS